I volunteer as a mentor in a group where most mentees are recent college grads or early 20s juniors. ADHD is a perennial topic of discussion because most of them (no exaggeration) have either received a diagnosis or have self-diagnosed as ADHD.
One very common struggle I see is when they take internet advice that tells them it’s okay to offload their own struggles on to other people. Unfortunately this blog gives similar advice:
> Focus on managing how your limitations affect others rather than trying to eliminate those limitations. This means:
> Being explicitly upfront about your administrative weaknesses early in relationships
> Giving trusted contacts alternative ways to reach you when truly urgent
> Building a reputation for being aware of your limitations rather than in denial about them
This commonly translates to them adopting ADHD as part of their public persona within the company, which they believe will grant them some degree of protection from consequences.
From what I’ve observed: More often than not this provides a false sense of security. They don’t intend for it to become a free pass, but after “coming out” as ADHD they get the wrong impression that the pressure is now off.
I think they intend to continue working on becoming better at managing their struggles, but it’s really easy to let the opposite happen: Once they think their diagnosis can be used as an excuse, they relax and let their behavior slip even further.
So be careful about getting the wrong idea from this line of thinking. It is good to acknowledge your difficulties and do things like ask other people to follow up if you don’t reply in a timely manner. It is important that you own up when you’ve dropped the ball. However, none of these things should be interpreted as a free pass or a loophole that shields you from consequences. That line of thinking, in my experience, is where people get themselves in trouble.
I think it's valid to still hold people to a certain standard, but the standard is adjusted to match your disability while focusing on executing the core job functions.
* Don't you think we would be on time if we could? *
It's not a matter of trying harder.
Yes we still have to do our core job functions the same as anyone else, but it's not fair to measure us on a quality the disability affects.
We don't get to ask a partially blind person to just look harder. We give them accommodations that let them do their job without relying on seeing.
It's called accommodation, not shielding from consequences.
I get to be late because I am not able to be always punctual. So my job has to accommodate me to help me do my job without relying on being on time. Just because I can sometimes try hard and be on time doesn't mean it's not a disability.
Depending on the job, being punctual can be critical to keeping customers happy.
If I’ve got a major customer complaining about a critical issue and has scheduled a call with various stakeholders (including us) to discuss/resolve it, then we can’t miss that call. Nor can we reschedule without extremely good cause.
If the disability affects a core job role then there are no reasonable accommodations.
A blind person can't be a fire lookout, but they can be a host/greeter even though most customers would like to be acknowledged when they enter. the workplace just needs to make some changes to help the person.
also I'm not sure if 'customer wants the person not to do something' is undue hardship. If the employer says my customer wants to work with someone who can see my face when I talk, does that mean that employer doesn't need to accommodate blind people?
Like maybe the accommodation in your example could be to have another person on the team join meetings with you to provide a few minutes of coverage if you're late.
If the job role really needs only one person to be exactly punctual all the time (does it really though?) then the eeoc advises to place the person in a different role with similar functions that aren't affected by the disability. read the guidance at eeoc.gov
Most of the time there are reasonable accommodations. It varies by person and the accommodations are specific to the role and person.
My point is that asking someone to just try harder is not the answer, and kind of ablist as it denies the reality of disability.
Especially when you frame it as an accusation of laziness or an excuse to slack off.
Almost anyone can diagnose if a person is blind if they’re acting in good faith but ADHD is far harder to pin down. At the moment the layman standard seems to be “can you convince a doctor/nurse practitioner to prescribe you amphetamines?”
The ADA covers mental disabilities like ADHD so anyone who actually needs accommodations can receive them if they follow the proper channels and get a legitimate doctor specializing in ADHD to diagnose them. In a career spanning nearly two decades I’ve only ever met one other person who followed the proper ADA accommodation route with HR (as opposed to accommodations for blindness, deafness, or chronic pain which were legion).
Speaking for myself, even with a legit diagnosis it was little more than a cover and self justification for drug abuse (yay NP who prescribed both Vyvanse and Adderall).
how does you thinking some people fake disabilities and that you have a substance problem have anything to do with my comment on people framing accommodations as an excuse to slack off?
Are you suggesting that you think your diagnosis is invalid and that should be taken as a data point in our discussion?
I think the answer is for you to stop taking drugs, not that there aren't people woth ADHD who need accommodations to do their job well.
It's also not anyone else's job to diagnose you but your doctor.
If they cant or wont get ADA accommodations officially through HR, I don’t care what their doctor says (I don’t have access to their real medical records for obvious privacy reasons). They might as well have a diagnosis from a food truck chef.
It’s not my place to tell anyone whether they actually have a disability, especially one as pernicious as ADHD, but it’s also not anyone’s job to accommodate slackers who doesn’t follow the proper ADA process.
Next time someone uses their ADHD as an excuse to slack off, go talk to HR about what accommodations they requested and whether or not they’re reasonable. Forcing coworkers to pick up the slack for an existing assignment isn’t reasonable - ADHD accommodations are taken care of at the management and planning levels, not during standups. Stuff like flexible work schedules and office environments that minimize distractions are reasonable, but it’s not a get out of jail free card for one’s duties.
who are you talking about and how does that pertain to this discussion? The fact that someone could lie or not do procedure properly is not relevant to the people who do. It's kind of insulting to bring that up in a good faith discussion to imply that we're all fakers. If you'd like to reply to anything I said instead of calling people names I'd be happy to discuss.
Imagine telling a quadriplegic something like this, though. The neurodiverse, which ADHD is a part, are always being told we still need to measure up to the standards of the non-disabled in some form or another. It’s always about how we shouldn’t offload our struggles on others. There’s no wheelchair for us, almost no one cares if our workplaces aren’t accommodating.
100% this. This often manifests as "It's not your fault but it is your responsibility." Which is a great thinking framework when it helps you accept what you have and do what you can do mitigate it.
But here's the kicker: our "what we can do" will never be enough to be neurotypical.
We'll need help, even when we're using all our coping mechanisms. And if we don't get that help, the outcome is simple: we're going to fail.
In my experience, the line is drawn, brightly, in one place: does the "disabled" person genuinely try to work with others, or do they expect to be given a free pass because they played the disability card?
I have worked with some severely disabled people. (Probably more than you have, given one of my past jobs.) Most of them worked their ass off to make things work out and for that they have my eternal respect, my cooperation, and the benefit of the doubt.
I have also worked with some people who just throw their hands up and say "but I'm disabled" whenever they are asked to do anything they don't want to do. I do not respect those people.
What kind of disabilities? Visible (missing or non-functional limbs) or invisible (chronic pain, adhd, depression) ones?
More specifically, how do you know whether they could or couldn't do the things you were asking them to do, especially if it was an invisible disability?
Doing it before isn't a good indicator.
Other people with the same disability doing it isn't a good indicator.
Not visibly trying isn't a good indicator.
Having a blowout (or not) isn't a good indicator.
Being too tired (or too wired) isn't a good indicator.
The issue here is at the end of the day, there is work to do, and results matter.
Everyone has finite shits to give.
If everything is going fine, other people will often be willing to pick up slack or adjust. If other people are exhausted, overworked, or have no more shits to give - they won’t. Or more precisely, at some point they can’t. Or suffer negative outcomes themselves.
Disabilities are called that because they make things harder, for the people who have them, and for those around them. Same with disorders.
> they make things harder, ... for those around them
Agreed. I think the point I'm trying to make is simple, to abuse your examples here: Your not giving a shit is neither my fault nor my problem.
And to generalize it, "Your problem with my personal trait is neither my fault nor my problem." Be that trait a disability, skin color, sexuality, gender, or nationality.
Because unfortunately disabilities are just targeted as all those other ones when people want a scapegoat.
I might be getting a bit philosophical, but that's what this feels like it boils down to. Person A is vocal about their dislike of something about Person B.
No, it's not. According to doctors, scientists, and the ADA.
That factual inaccuracy aside, would you consider someone with chronic back pain to not have a disability since they can take heavy painkillers every day for the rest of their lives? Or someone who is legally blind but who can put on glasses?
Legally blind is tested with corrective lenses, if your vision can be improved to 20/200 in either eye by wearing glasses you wouldn’t qualify as legally blind (in the US)
It's pretty unreasonable to compare one relatively minor disability to an extreme physical one that inhibits basic things like brushing your teeth or going to the bathroom.
ADHD doesn't stop you from doing those basic things does it?
For many people with ADHD it doesn't make things impossible, just much more difficult.
I think the point that the person you're trying to make is that too many people with an ADHD diagnosis think that being public with that diagnosis gives them a free pass to not over come the difficulties they face.
> ADHD doesn't stop you from doing those basic things does it?
Ironic that you picked those two - it absolutely does.
ADHD (and autism) have trouble forming habits - remembering to brush your teeth is something that's a real problem for most folks who have ADHD. Not to mention showering, deodorant, etc.
As for the bathroom, most ADHD people will hyperfocus to the point where they either don't notice they have to use the bathroom, sometimes for an entire work day at a time. Constipation and minor incontinence are not as uncommon as we wish.
> For many people with ADHD it doesn't make things impossible, just much more difficult.
Imagine you have a set of spoons with which to do work. For a NT, doing something like brushing your teeth is a habit, so it doesn't take a spoon. For a ND, the habit fails to form, so they have to exert mental energy to do it. Two spoons.
Keep this up for an entire day, and by the time you have to cook dinner, ND just don't eat because they've been out of spoons since mid-day. The NT cooks dinner and has a few spoons left over to work on their hobby.
Difficult might as well be impossible when you're out of energy. Or spoons.
EDIT: Wow. This blew up. I wouldn't mind chatting more about it.
While I'm not also a quadrapeligic I feel confident that ADHD in general and quadrapelgia are not comparable.
I acknowledge that there are varying levels of severity of ADHD but very few of the instances of ADHD are comparable to such a profound disability as quadrapelgia.
You don’t compare disabilities, none are worse or lesser than others, it’s simply a disability. Anyone, even those with disabilities, who try and argue one type is worse off than another type are simply being ableist by trying to minimize or marginalize that person’s struggles.
You don't think that there are objective and measurable differences in disabilities?
Let's take plegia for example -- all other things being equal which is worse being monoplegic, paraplegic, triplegic, or quadriplegic?
Not recognizing objective differences in quality of life associated with varying disabilities does a disservice to those people with extreme disabilities and minimizes and marginalizes their struggles.
You’ve taken the opposite of what I said. Everyone’s disability is a struggle. Everyone’s life is a struggle. We help each other to navigate life and don’t compare.
Answer this: what’s the end goal of comparing disabilities? I’d argue it’s simply to minimize the “easier” ones. Every struggle is hard for the disabled, bar none. There is no logical reason to compare other than to minimize someone’s struggle, so just avoid doing that. Instead, try and figure out how you can help those around you who struggle, disabled or not.
You used very poor examples and that’s okay. You don’t have to be perfect - it’s totally acceptable to wade into a conversation, realize you really weren’t qualified and back out. You don’t have to resort to this level of aggressive debate.
> I think the point that the person you're trying to make is that too many people with an ADHD diagnosis think that being public with that diagnosis gives them a free pass to not over come the difficulties they face.
Yea, and my point was: imagine telling a quadriplegic they should just try harder to walk, or alternatively that they should try to keep it secret. It’s a stupid idea.
You’re clearly uninformed about this topic, and should research it better.
“Research shows that adults with ADHD are 5 times more likely to attempt suicide. 1 in 4 women with ADHD have made attempts on their life, while men are more likely to end their life. Accidental death is also common.”
I’m sorry bud, but I really don’t think you understand the topic. The idea is that people with different types of disabilities deserve an appropriate level of accommodation. It’s not a race or any kind of rivalry, or even a competition.
It’s about being a decent human being who can think critically.
Congratulations on having ADHD at a level where your coping mechanisms work (and appear to work pretty well). Not everyone is so lucky.
Or to put it another way, a broken toe and a broken femur are both categorized as broken bones, but one is much more serious and has complications the other does not.
We understand that your disability is much worse than the rest of us. Everyone else should stop what they’re doing to accommodate your severe disability.
This is why I don’t want to be diagnosed. I only claim to have probable ADHD when I am trying to help other people who do or might do.
Without claiming any disability, I say what I’m good at and offer to do it. I am respected for what I contribute and forgiven for what I don’t.
I married someone who does planning, she married someone who makes money on his ideas. She runs my business, I talk to clients and teach my classes and (slowly) write books.
> it's like trying to teach advanced machine learning to someone with an IQ of 100. No matter how well-intentioned the advice or how clear the potential benefits, there's a fundamental mismatch between the cognitive requirements of the task and the available cognitive machinery.
This obviously isn't core to the point OP is making, but I find it hard to believe that someone of "average" intelligence can't learn about advanced machine learning.
What is obvious is that OP is really into IQ elitism. Looking at the ‘A More Realistic Framework’ suggestions, it asks people to aim for the bare minimum.
No, it's not suggesting the bare minimum. It's asking the person to openly do what can be proven to provide the best value as long as the missed administrative tasks or fails are down-playable enough to not damage your reputation. This is a very easy framework for me to funnel my thought process through.
Recently, I've been in the position where I'm the only one taking ownership of new work and initiatives, sometimes to my own detriment. For example, I took on a feature that required an entire validation system be put in place. Though I succeeded in successfully completing the system, the feature was not fully complete. The validation system was not visible. Though if leverage, it would lighten everyones load, it largely went unnoticed and what was observed was that I pushed out a buggy feature. Though I resolved the bugs within a sprint, my reputation was damaged to the point where I took on a new feature and promised it would be done in a sprint. I succeeded but wasn't able to complete it due to the api team only finishing 2-3 of 8 apis. This sort of test I made for myself also had low visibility so even though it was an impressive feat by my team's efforts, it also largely went unnoticed.
Though the author is wrong to equate work-throughput with IQ, he's right to find a way to inform trusted management with this work ethic and he's right to make sure when high value tasks are taken on, that it be made clear to product so credit can be given.
I have team members that are doing the bare minimum but cross lots of t's and dot many i's and that gets them equal recognition as me who often misses deadlines but does lots of heavy lifting.
I think it is core — the premise is that ADHD in some presentations makes basic administrative/maintenance activity difficult or impossible.
With machine learning, the concept or layman level explanation to support the application of the tech is definitely doable for the average person. But the average person won’t be able to get the math.
Folks I know with ADHD generally adapt well, with systems or coaching that they get from professionals or folks supporting them. Everyone is different, of course, and folks struggle with different things.
He’s right with the other stuff too imo. People who deliver get grace from non-core failures.
I think they are right. Advanced ML requires both IQ and career dedication. Doing say the intro YT series building yoyr own LLM and understanding and sucessfully using PyTorch data strucutres in 3 even 4 dimensional (as in an array of array of array of arrays) doing matrix algebra...
I would say this gets possible at 120 and only easy at 140 at a guess.
Anecdotally, as part of my job, I've taught ML concepts to a lot of people. I don't know if I've ever worked with anyone who was simply too "unintelligent" to grasp things. The bottleneck, as for most things in my experience, is time and motivation. In any niche of ML, there's just a lot of things to learn, particularly if you aren't starting with a particularly math-y background.
You were probably working at a fairly advanced tech company. As were the people you were teaching.
If by "ML concepts" you mean "how to implement ML" - do you really think that people who got to a job that required learning this, represent the population IQ distribution?
I "have" ADHD, although I don't believe in it conceptually and I don't take any drugs for it. I think if you poly-score people on impulse control, attention span, time sensitivity, organic recall of pertinent time-sensitive information, etc. you'll find that if you arrange all the scores from best to worst everyone under the 40th percent mark "has ADHD". Below maybe the 10th percentile you'll find that without stimulants it's unlikely that the person will function well in a task-based time-sensitive environment with delayed feedback loops for task completion.
Accepting the framing that ADHD does exist, it feels like brain damage. Every year growing up, in any group of kids I was among the most immature, the most off-task, the most distracted, and the most forgetful. I am plenty smart, move very quickly, and have accomplished plenty, but my entire life has been defined by being more bored, forgetful, and immature than nearly every single person I've been close to. My wife (performs very well on relevant metrics) says it's extremely noticeable and unusual from the outside. Over time I've learned to heavily lean on coping mechanisms (my phone rings about 35 times per day with timers I snooze tactically, I leave my keys in my bag any time I go places so I can't leave without the bag, etc.) No amount of character development schemes, punishments, shaming, positive skill practicing etc. has changed my natural proclivities in the slightest, although many days of good sleep and diet can sometimes produce a bit of a sustained flow state. Sometimes I wonder if I just lack some kind of ion in my blood.
My coworkers sometimes tell me they feel like they have ADHD. Then I watch them listen to someone talk about a subject they find boring for 5 minutes without drifting off or fidgeting, and then remember off the top of their heads to respond to outstanding emails. Come on guys, if we're going to make up conditions we should at least reserve the label for people that it describes accurately.
> I "have" ADHD, although I don't believe in it conceptually
Congratulations on getting your Doctorate of Psychiatry. Glad you've single handedly debunked a century of study with your belief.
On a more serious note, I'm glad your symptoms are addressable with coping mechanisms. A lot of folks can't. And your "40%" is actually closer to 5%, based on scientists who research and give talks on this mental disorder.
I think their opinion is along the lines of “no one is ‘inflicted’ by ADHD, and there is also no permanent cure for it, because the disorder can simply be redefined as being those who are in the lowest quartile or even the lowest 10% of X, Y, Z cognitive metrics.”
Imagine there were a pill that could boost your IQ score by 25% but in order to receive a prescription you need to have an IQ in the lowest quartile. Such a pill could also help already smart people simply become smarter.
Thats the main contention: there are two groups: (a) people who actually experience debilitating symptoms that significantly impact their life requiring medication, and (b) people who are simply looking for an edge by using medication, perhaps even convinced to do so by ads on TikTok or Instagram under the guise if ADHD.
Edit: The IQ score medication analogy is only meant to be illustrative. I don’t mean to imply that IQ and ADHD are somehow connected.
Respectfully, disorder already has a meaning. And it's a meaning enshrined in medicine and law (ADA). "Redefining" disorder does nothing but hurt people who have a disorder.
And ADHD has no correlation with IQ (which I think you know, but it' not just a focus sliding scale either). It's a disorder that encompasses the symptoms of time blindness, a lack of ability to control focus, emotional disregulation, rejection sensitivity dysphoria, reduced working memory, an inability to form habits, and executive dysfunction.
It's also associated with a physical change in the brain.
I added an “edit” to clarify I don’t believe IQ and ADHD are connected.
“Redefining” could have instead said “Reinterpreting”.
The reality is the diagnosis for these disorders are completely subjective. The same logic could be applied to depression and SSRIs. It’s not like a blood test that tells me I have high cholesterol. It takes dozens of hours with a qualified medical professional to seriously diagnose someone with high confidence.
Also agree there are studies correlating it with physical changes in the brain. But those studies aren’t fully fleshed out and not useful for diagnosis. There isn’t a brain scan that can detect ADHD.
I think it's important to note that even if there were, it wouldn't change the inherently arbitrary nature of ADHD diagnoses (as opposed to the more objective presence of a bacterial infection or an ACL tear). Such a brain scan would legitimize the careers of thousands of people and be deeply celebrated by insurers and physicians alike, as it would dramatically simplify the diagnostic procedure, but the scan would still just be "identifying brains that fall into several of these metrics 1-N we wrote down in the DSM". It would be possible to change the DSM such that the brain scan would have to be adjusted as well, which is very difficult to do with other conditions that are more obviously "real".
My two cents, although I admit I've put more like six cents into this thread in total, is that 95% of the suffering that those "with ADHD" experience come from poorly-designed schools and businesses, which keep them captured, tracked, and timed for deeply questionable societal benefits. I'm not about to say you can operate a space station or manufacture semiconductors or supply the US cold stowage network without a good amount of capturing, tracking, and timing, but I am going to say that much of the psychological torment ADHD-havers endure is because they're failing to live up to stupid, useless goals set by people with misguided ideas about why the goals exist.
You misinterpreted the part of the comment you referred to. They aren't referring to redefining the word "disorder", but "the disorder", as in "ADHD". What they were referring to with the definition is how the definition of ADHD is completely arbitrarily defined, as the diagnosis isn't based on any genetic marker.
> ... how the definition of ADHD is completely arbitrarily defined, as the diagnosis isn't based on any genetic marker.
Did you know that 90% of cases of ALS aren't "based on any genetic marker"? Does that mean ALS is "arbitrarily defined"? What does that even mean? Are you saying it isn't real?
Neither is depression, PTSD, autism, chronic pain, schizophrenia, narcissism, MPD, and so forth. But they all exist. And they can all be debilitating to the point of becoming a disorder. They all have treatments according to their classification.
Being invisible doesn't make it not be a disorder.
> I think their opinion is along the lines of “no one is ‘inflicted’ by ADHD, and there is also no permanent cure for it, because the disorder can simply be redefined as being those who are in the lowest quartile or even the lowest 10% of X, Y, Z cognitive metrics.”
That's not how ADHD is defined, though.
> Imagine there were a pill that could boost your IQ score by 25% but in order to receive a prescription you need to have an IQ in the lowest quartile. Such a pill could also help already smart people simply become smarter.
Yeah, that's a nice hypothetical but that's not how ADHD meds work; boosting dopamine out of the normal range does not continue to have beneficial impacts to executive function, instead it leads to anxiety, insomnia, aggression, and hallucinations. That's one of the reasons dosing for ADHD meds tends to start on the low end and be carefully titrated up to what works for the individual.
Are you saying no one without ADHD takes prescribed medication?
When I was in college people with prescriptions would sell their pills for $5-10 each (10+ years ago in Boston). That’s $300 for a month supply purchased by fellow students who weren’t diagnosed, but used it to cram for exams and studying and concentrating during exams.
If what you say is true, then the free market (black market) for adderall wouldn’t be so lucrative.
Perhaps you haven’t been exposed to the plethora of Instagram ads convincing kids they have ADD based on a 5 question survey and prescribed without any other criteria besides “is trouble concentrating impacting your work or personal life?” - these days it’s literally that simple, quick telegealth appointment, say concentrating impacts your work life, and there you have it, you officially have ADD.
This thread is going on a ton of tangents. My original point was simply that diagnosis is subjective and relative to the people around you. Second point is the meds will help anyone who takes it with improving concentration and making it possible to increase productivity substantially not just for short bursts but for extended periods of time (months/years). I think both points still stand
(And none of what I’m saying invalidates the seriousness of the disorder for people who “really have it”. I fully believe there are people who find the condition truly debilitating. But there are also loads of people who are diagnosed through instagram or TikTok ads because “concentrating is hard” and “motivation is difficult” and other obvious statements that resonate with a majority of college kids, for example)
> Are you saying no one without ADHD takes prescribed medication?
No, I'm saying that the cognitive effect on function of someone without ADHD taking ADHD medicine isn't the same directionally as that of someone with ADHD taking it, the way the upthread proposed analogy of "a drug that increases IQ score by 25%" but which is only prescribed to those with IQ in the lowest quintile framed the situation. Excess dopamine impairs function in a different way that dopamine deficit, it doesn't increase it beyond what is seen with normal dopamine.
> If what you say is true, then the free market (black market) for adderall wouldn’t be so lucrative.
It is true, but the black market for adderall isn't mostly taking it for the same effect as people with ADHD are (some are, because there are still biases and access issues which prevent or delay diagnoses for people with ADHD, as well as deliberate, government-created supply shortages in the legal market.) But largely are taking it for wakefulness (an effect of dopamine surplus), and because dopamine surplus is part of the brain's reward system such that things which have been experienced which produce it are actively sought out. Again, this is why therapeutic dosages for ADHD are titrated to avoid going overboard.
Everywhere, all the time, at all age brackets. It's absolutely terrible, having suffered a terrible amphetamine addiction in my past.
Sufferers of real ADHD need to understand that when people critique the guidelines, they're critiquing the fact that this is possible, and its leading to serious problems getting on with life.
I think they're just in a bubble, gotta remember that in tech the percentage is bound to be a lot higher Then for the general population.
You're also taking that initial statement way too serious, the rest of the comment kinda contextualized it and essentially admitted that it does exist, but that it's more of a range then a binary. And that's in line with the medical science.
I've actually never heard anyone describe it as a binary, but maybe that's just my bubble.
Thanks to another prevalent symptom of ADHD - emotional disregulation - I very well could have overreacted. In my defense, the "It's not a real thing" and "you're just lazy" really get old after the 100th time hearing them this week.
Control over concentration is only one symptom of ADHD, and there are discernible differences that make ADHD brains look different in CT and MRI scans. So it's a bit closer to binary than "everyone in the world is somewhere on the ADHD spectrum".
Plus, the final word in the ADHD acronym is "Disorder" - so if it's not impairing your ability to live and participate in society, by definition you don't have ADHD.
I wouldn't say you overreacted. It's impossible to both convey and read tone over the internet, so there's no way for you to know that I don't mean to be insulting. I also like to write in a polarizing and cynical manner.
Whatever negative label you've had applied to you as a result of ADHD, I likely have had the same applied to me. My choice to not use any stimulants is both indeed a privilege of my "symptoms" not reaching a point where I can't function in day-to-day life, but also an ideological choice, because I have hurt my own career, screwed up projects, and progressed much more slowly than I would have if I were on Adderall or Ritalin or whatever else they're prescribing now.
The reason that I persist with the claim that "ADHD doesn't exist" is exactly what you said here:
> If it's not impairing your ability to live and participate in society, by definition you don't have ADHD.
The problem is not my brain, the problem is the arbitrary demands of society. This is not an emotional attempt to preserve my self-esteem--I like myself just fine and always have--but a pragmatic observation that diagnosing "disorders" with acronyms and developing "treatments" legitimizes the framing that the society that I'm chafing with as a result of having some cognitive deficits relative to the rest of the population is somehow more "real" or "official" or "objective" than I am.
It's like if every day to get to work, you had to walk up huge stairs, and anyone under 5'6" had a tough time getting up the stairs, and then doctors came up with HDS (Height Deficiency Syndrome) and prescribed growth hormones and stilts. You get a bunch of people walking around on stilts telling each other they have HDS. Over time, you barely even need to be examined to get a stilt prescription, they just give you the HDS diagnosis soon as you look like you're not going to pass 5'6" by 18. Now you've got a society that is comfortable with the knowledge that short people have HDS and tall people don't, without thinking about the fact that whoever built the stairs could simply have made smaller stairs that other people could walk up more easily.
I would really prefer that people start wondering en masse if, in the age of incredible technological abundance we currently enjoy, it's really necessary that every industry, even ones that don't require highly time-sensitive detail-oriented work, function with the rigor and precision of a munitions factory.
Well, society isn't going to change to make 5% of the population with an invisible disorder better.
And I think even given that, the "it's society that's the problem" is still wrong. Because (from another thread), ADHD is more than just a concentration problem. It's a disorder that encompasses the symptoms of time blindness, a lack of ability to control focus, emotional disregulation, rejection sensitivity dysphoria, reduced working memory, an inability to form habits, and executive dysfunction. No number of "hunter gatherer" society norms would explain all of these.
I disagree strongly with the grandparent comment, but this is about as useful as commenting
"Congratulations on getting your Doctorate of Sacred Theology. Glad you've single handedly debunked a millenium of study with your belief" would be when I comment that I'm an atheist.
FWIW, this comment falls afoul of the guidelines as well, and is even less useful since I did follow my opening with a real discussion. To quote the guidelines, report it to the moderators if you feel it's sufficiently problematic.
I didn't say that your comment was an egregious violation of the guideline - had it been, I'd have reported it instead.
I reminded you that the guideline exists because it's good advice in this case, and had you edited your comment to get rid of the snark (as the guidelines suggest), you could have had a chance of persuading instead of alienating its audience. Too bad.
MRIs show study after study that ADHD is real. Its been shown that ADHD is either the inability or significant reduction of processing dopamine, or the inability or significant increase in dopamine production. That’s all there is to it.
Tell a blind person to simple try harder in seeing, and that you don’t believe being blind is “a thing”.
At its core, ADHD's main mechanistic difference is undeniably an executive function deficit -- the frontal lobe not being activated enough to properly regulate functions of the rest of the brain or exert executive planning and follow-through.
The "paradoxical" effects of ADHD stimulant-type medications is the most direct indicator that this is indeed the case: taking a CNS stimulant normally causes more arousal, agitation, and activity in NT individuals.
But in ADHD individuals, CNS stimulants up-regulate frontal lobe activity, which manifests as a relaxant, since the frontal lobe is doing a better job of regulating and stabilizing the rest of the brain. Executive function also improves considerably.
So the most objectively measurable symptom of ADHD is whether this paradoxical behavioral alteration occurs from taking a CNS stimulant.
You can argue all you like about whether ADHD is within this or that percentile threshold -- but you can't argue with a proven, consistent, clinical result that points strongly to under-functioning of the frontal lobe in individuals with ADHD.
I've experienced this myself. My quality of life is profoundly different after taking Ritalin. I feel more relaxed; the buzzing and noise in my head is significantly reduced. I stop feeling the profound urge to get distracted like Doug the dog from the movie Up: ... "squirrel!"
I don't understand why people consistently seem to think that I am telling people that their experience "isn't real" or that their brains and behavior aren't different from the majority, or that everyone can get around it by "trying harder". None of that is what I'm saying. I could be diagnosed with a real, clinical case of ADHD pretty immediately if I so desired. Going by the dictionary definition, I "have it" and have "had it" for my entire life. My father "has it" to the same degree that I do and is medicated for it. My life has been a great deal harder than it would have been had I taken stimulants.
My point is that, unlike people who have a fracture in their femur vs. people who don't, the "significant reduction" of dopamine processing metric, when codified, is a pretty consistent, smooth line across the population. There are a group of people who are seriously dopamine-processing-reduced, and then a huge grey area with people who kind of are and then kind of aren't, and then there's group of people whose dopamine-processing ability defines the "baseline" against which ADHD is constructed. ADHD is a four letter label that was only invented to help doctors help people deal with difficulties they have with executive functioning, given that modern society demands a baseline of executive function out of citizens if you want to receive food, shelter, salary, and promotions.
In recent years, the "ADHD boundary" has been expanding to capture more people in the grey area as doctors, psychiatrists, and insurers play looser with the definition of ADHD than they did when it was first invented. But at its core, the condition is literally "compared to this other group of people, you have a harder time at certain important tasks than they do". Is that a "real condition" in the same way that COVID-19 is a real condition? I say not; it's a methodological shorthand.
I am very aware that the brains of certain people work differently than others, and that in "ADHD brains" (a group which includes mine) it is possible to use a brain scan to observe differences relative to that "normal group of people". But if you took scans of the "least ADHD" group, you could find that their brains differ as well, and they have certain cognitive advantages compared to the new baseline of middle-ground brains. We could call that "Attention Surplus Normal-activity Advantage". But it would be stupid to label them with ASNA. Everyone would be aware that the four-letter acronym is just an arbitrary shorthand to describe a group of people that can be diagnostically clustered together relative to everyone else. The "advantage" would be exactly as real as the "disorder".
> study after study that ADHD is real. Its been shown that ADHD is either the inability or significant reduction of processing dopamine, or the inability or significant increase in dopamine production. That’s all there is to it.
Its not, though, because while the dopamine/norepinephrine chain seems to be the main issue in ADHD, serotonin also seems to be implicated, as low serotonin levels are associated with it and serotonin-targeting interventions also seem to help.
But, yeah, your more general point is correct; ADHD is undeniably a real condition.
I have to constantly fight the struggle OP is describing, and one thing I’ve never tried is being upfront and honest about my shortcomings… I just get upset with myself and start writing post it notes about doing better, actions to take, and sticking them all over the place. I can’t even imagine the world where I share this about myself and it’s well received by people who, at the core, just want me to deliver a very steady stream of work they can plan for.
You don't always need to announce it to everyone. You can try talking to HR and asking for accommodations (which someone with ADHD is eligible for through the ADA). And the nice thing there is you don't have to tell anyone else.
Accommodations can include things as simple as leeway for coming in late, or with deadlines. They can even go up to removing specific requirements from your role.
I was diagnosed with ADHD but I still think of myself as a lazy cunt. That probably doesn't help reputation either, I'm sure I project this belief outwards, even unintentionally. Other ADHD-afflicted individuals I've talked to about this report similar.
My neurologist has a LOTS of patients.
All of those with either Autism or ADHD / similar symptoms claim that they feel they don't get enough work done.
I start to believe that we are overly self-critical, and that the actual workers are having better ways of hiding their incompetence :D
If you felt satisfied with your productivity, why would you seek help? So there's definitely a selection bias there. Likewise for those whose "locus of control"[1] is biased toward external factors--i.e. you ascribe lack of success to factors outside yourself.
Similarly, AFAIU, time and energy spent in self-reflection also tends to positively correlate with neuroticism--e.g. feelings of guilt and inadequacy. If you're not high on self-reflection (there's a negative correlation with extroversion), you're less likely to experience negative self-esteem, at least in a conscious way.
I know ADHD correlates more strongly with some personality types than others, but by and large I believe people with ADHD (like everybody else) are spread across the spectrum along all these various axes, and it's only at some ends of certain axes that they're likely to seek assistance for themselves.
I've been diagnosed, and both before and after, sheer terror of being seen that way has helped keep me generally productive at work for decades. But I run into something that seems related - I feel like a fraud, particularly when I get compliments or recognition at work. Yes, I am actually doing the work - it. But I know I could be far more effective if I could focus better. So I always feel like I'm only accomplishing a small fraction of what I could... and I expect people to realize that any moment now.
I had this happen at my last job. Got a new boss who was closer to the situation and ended up bouncing me over the course of a six month pip. I was so bored, and the hard problems always got taken by the same guy who they’d just hand stuff of to.
At my new job I interviewed into a promotion and am a team lead. My focus is always on whatever is the most challenging technical tasks. Once we finish building a product, someone else takes over maintenance and we get a new project. It’s fantastic because I’m always at the edge of what I know and writing brand new stuff, which I exactly what I love. I find this deeply satisfying and it helps rebuff that feeling of being a fraud. I definitely prefer to be a medium sized fish in a small pond (where I’m a pretty smart guy at a place that doesn’t necessarily need world class engineers) vs being a medium sized fish in a large pond.
The more boring my work is the worse I do at my job, and I’m lucky that in my position at this point I basically only focus on the novelties and intricacies of the most challenging tech problems the company has to offer.
> I feel like a fraud, particularly when I get compliments or recognition at work. Yes, I am actually doing the work - it. But I know I could be far more effective if I could focus better. So I always feel like I'm only accomplishing a small fraction of what I could... and I expect people to realize that any moment now.
This is imposter syndrome[0]. Particularly feeling like a fraud, disassociation from compliments, and expecting people to find out you're a fraud. I think it's fairly common for some jobs/roles (software developers at Google, for example). I also think it's fairly common for people with ADHD.
You can still do more and do better (e.g. by better coping with your ADHD symptoms), that's normal and healthy to an extent. It's just that your self-perception is probably a bit too negatively biased. It's normal to have a negatively biased self-perception, but my guess is that your self-perception got warped a bit too much from decades of "sheer terror".
I can't really speak directly from experience with imposter syndrome, but what currently helps me deal with negative self-perception is acknowledgement and acceptance:
* cognitive reflection: Understand and acknowledge that many of my self-thoughts are negatively biased[1].
* meditative reflection[2]: Practice unconditional acceptance. Accept everything, accept my own performance, accept my negative thoughts of my own performance, accept my feelings of ineptitude.
... Unless "I'm only accomplishing a small fraction of what I could... I expect people to realize that any moment now" actually means that you expect people to find out that you're secretly really awesome and deep-down you're actually way better than all of them. That's probably not imposter syndrome.
[2] I don't really meditate per se regularly, I'm trying to illustrate that there are different ways to mentally reflect. Rational, logical, emotional, spiritual, whatever.
You're just carrying on what you were called by your parents, teachers, coaches, and peers. ADHD and being called lazy is common. And when we're told that so frequently, we begin to believe it.
Even though it's not true. Sometimes no amount of mental effort can break past the barriers we face on a daily, hourly, even minute by minute basis.
> Being explicitly upfront about your administrative weaknesses early in relationships
This sounds like a Good Thing, and I'm sure for some people it's a good idea, but in my experience, frontloading this sort of stuff tends to backfire.
The problem is that most[0] people don't know how to deal with special needs[1]
If you focus on the facts and "your administrative weaknesses" a lot of people just hear excuses and think you're incompetent.
If you try to explain it as a medical thing first, you might get the "you don't look autistic" response -- they think you are putting yourself down -- but the response I've had even more often is "what does that mean?".
Now you have to work to convince them that you are a liability.
A strange game. The only way to win is to not[2] play.
[0] "most": a population large enough that you can't safely ignore their existence. Source? what I reckon.
[1] I don't really like to use the phrase, but I mean the literal meaning of the words and also that's often how they see it.
I have ADHD and sometimes my brain wants to do admin work but sometimes it doesn’t. It’s actually hard to predict, so that makes it even worse. If I do the admin stuff one time then people assume I’ll always do it but then next time I let it slip and that has negative consequences.
It kind of feels like I’m just a passenger and my subconscious is doing the driving in terms of my decisions if what to focus on.
I don't officially "have ADHD" but I have related things that often come with "ADHD-like symptoms" which as I've gotten older seem to either get worse or just come to the forefront more. So I open this article looking for something and... man, it is really shocking and bizarre to see basically my entire life-success strategy independently written down by someone else.
Some are worthy of specific comment:
> These suggestions assume that the primary challenge is knowing what to do rather than the neurological capacity to consistently execute such systems.
YES YES YES YES YES. I am utterly sick of being told to make a to-do list (thanks, therapist, last Monday). I have a list. I have a half-dozen discarded lists. Lists are not the problem. Someday I will find the solution?
> Be exceptionally helpful when you can, so people are more forgiving when you drop administrative balls
It's kind of hilarious to see this written down, because usually when people seek me out for help (or I go to them to help)... it's something novel or at least a change of pace for me... so it automatically activates the novelty circuits in my brain and I get really into helping out anyway. Brains are weird.
> Being explicitly upfront about your administrative weaknesses early in relationships
This one caught some flak upthread but for me it is as simple as saying "hey, I'm not always great about responding to pings, if it's important just ping me twice and that usually works" (which, for me, it does). Saying that kind of little thing explicitly can go a long way.
> it's like trying to teach advanced machine learning to someone with an IQ of 100.
Everyone already agrees this is ridiculous, but I have to say it too: this is ridiculous.
This article hits home so precisely -- not personally but in terms of those who I've worked with in the past, and in particular the reputation bits.
It was been painful to watch, to be honest, because the impact on our team had been so acute, and it simply never got better after so much effort on the part of management, other engineers, etc.
Where I diverge with base assumptions however is that I suspect these particular people had been misdiagnosed with ADHD, were given medication, and it was the medication that led them to drop the ball. Why? Basic physiological needs were never being met, again and again. They were constantly reporting insomnia, missing meals, fatigue and all of the things you associate with stimulants being either misused or abused. Having _been there_, it was easy to spot. And I think this sort of thing is tragically common in our field, and is rarely confronted because of identity issues associated with medical labels.
You seem to be saying that people presenting with classic symptoms of ADHD clearly don’t have it because stimulant abuse can also cause those symptoms?
Sure, people get misdiagnosed or purposely lie to get meds, but tons of people legitimately have the condition. Insomnia, poor basic self care, and fatigue (hello insomnia among others) are 100% symptoms of the condition. Taking medication doesn’t “fix” ADHD, it helps some people cope better in some ways.
I'm speaking only to the high rate of over-prescription and misdiagnosis (this is a fact), and how it's very likely that more than a few people are finding their lives more difficult with medication. The potential for spiraling out is certainly there with amphetamines, and it can sneak up on you, especially when basic physiological needs are no longer being met. Having known these people for a good while, I think they fell squarely into this category.
I have adhd one way I get myself to do my administrative tasks is by trying to somehow mentally connect it to a goal that I am hyper focused on already. Another thing that helps me personally is running as it helps me center my thoughts to find my next step to advance to the goal(s) I am trying to achieve.
If you're interested in figuring out how to gain focus / concentration in life without having to get an adderall prescription, look into Samādhi.
small disclaimer: You probably can't choose to only gain focus / concentration if you embark on this path. Other stuff is going to come along with it, since technically speaking, you'll be unveiling the nature of consciousness in the process.
It's less useful that the things most often set aside are the most mundane but required parts of life.
For example: brushing your teeth. Showering. Getting prescriptions. Scheduling and following through with doctor's appointments. Paying bills (thank the gods for autopay). House repairs. Calling someone to do house repairs. Going to meetings at work. Remembering to leave for work on time. Remembering your wallet.
I have extreme adhd. I have zero struggles with what the article describes. I am extremely detailed oriented in every aspect of my life. I just can’t bring myself to sit and work on the most difficult and meaningful things unless they’re highly novel and I happen to find some sort of groove which is usually short lived.
Not sure the point of my comment. Maybe just to shed light on now it can be different. I would also never in a million years admit my adhd in a professional setting. It’s really stigmatized
I'm also the complete opposite of the ADHD types who forget things, are late, miss details, etc. I'm pretty sure that happened because I subconsciously developed a whole series of tactics and systems to make life less challenging over the years. But that just added new issues around living and dying by to-do lists, becoming addicted to "accomplishment" (at any level), constantly in my head 24/7 about what I need to do next, what hasn't gotten done, how I'm going to do all the things I want to finish. Also wouldn't dream of announcing this to colleagues.
> it's like trying to teach advanced machine learning to someone with an IQ of 100. No matter how well-intentioned the advice or how clear the potential benefits, there's a fundamental mismatch between the cognitive requirements of the task and the available cognitive machinery.
couldn't the same be said about adhd? or looking at it from the other side by the author's terms wouldn't a sub-100-iq machine learning enthusiast be also entitled to special treatment so s/he can work with it? isn't it fair to say that adhd relates to non-adhd like sub-100-iq to plus-100-iq? again, just taking the author at face value.
Maybe I have something like thus but admin tasks are a real challenge. Monday morning my heart wants to code and be in flow... but I know I need to plan future initatives, communicate stuff and worst of all make phone calls for personal stuff.
This is a pretty good article, from my point of view as an undiagnosed probable ADHD sufferer (I dropped out of high school over this kind of thing).
I wrote a book about my coping strategies— which invert most of the common productivity-fetish advice. For instance, I value procrastination. It has important benefits.
A key move for me was to stop thinking of my mind as if it were a power boat and start thinking of it as a sailboat. Hence my book on professional self-education: Secrets of a Buccaneer-Scholar.
Another key move was to recognize that discipline is not my road to getting things done. Rather, my motivator is helping people.
I am also usually very careful about what I promise. Most of my promises are to do things that I have already completed, or as near as.
Of cause everybody prefers the new and shiny but not executing on what's important is simply lazyness and lack of will.
The cherry on top is the comparison of the impossibly of teaching advanced machine learning to someone of average IQ -- clearly indicating that they assume to be of higher IQ since they have grasped that topic.
OP seems to be a low performer thinking of himself as high performer held back by circumstances and not themselves
In normal people, dopamine and norepinephrine are released in certain parts of the brain while performing routine and administrative tasks and also anticipation. In people with ADHD, it doesn't happen properly. If a (cruel and unethical) experiment was performed on you where your dopamine signaling was lowered, you'd understand this in a jiffy.
May I suggest not downvoting this into oblivion? We need to shine a light on this type of thinking, as it is representative of many others towards ADHDers (including many ADHDers themselves...). I have this wrestling match internally on the daily - "Am I being lazy right now or suffering from ADHD? Can I power through with determination and grit, or soften my approach and do an end-around using tactics learned in therapy?" Magnify that x1000000.
We've all encountered (in person or online) self-diagnosers, and even worse, those who make ADHD their entire personality, and calls for the world to change itself to make life easier for others. If that's your most frequent engagement with ADHD, I get how you could have OP's type of response.
I volunteer as a mentor in a group where most mentees are recent college grads or early 20s juniors. ADHD is a perennial topic of discussion because most of them (no exaggeration) have either received a diagnosis or have self-diagnosed as ADHD.
One very common struggle I see is when they take internet advice that tells them it’s okay to offload their own struggles on to other people. Unfortunately this blog gives similar advice:
> Focus on managing how your limitations affect others rather than trying to eliminate those limitations. This means: > Being explicitly upfront about your administrative weaknesses early in relationships > Giving trusted contacts alternative ways to reach you when truly urgent > Building a reputation for being aware of your limitations rather than in denial about them
This commonly translates to them adopting ADHD as part of their public persona within the company, which they believe will grant them some degree of protection from consequences.
From what I’ve observed: More often than not this provides a false sense of security. They don’t intend for it to become a free pass, but after “coming out” as ADHD they get the wrong impression that the pressure is now off.
I think they intend to continue working on becoming better at managing their struggles, but it’s really easy to let the opposite happen: Once they think their diagnosis can be used as an excuse, they relax and let their behavior slip even further.
So be careful about getting the wrong idea from this line of thinking. It is good to acknowledge your difficulties and do things like ask other people to follow up if you don’t reply in a timely manner. It is important that you own up when you’ve dropped the ball. However, none of these things should be interpreted as a free pass or a loophole that shields you from consequences. That line of thinking, in my experience, is where people get themselves in trouble.
I think it's valid to still hold people to a certain standard, but the standard is adjusted to match your disability while focusing on executing the core job functions.
* Don't you think we would be on time if we could? * It's not a matter of trying harder.
Yes we still have to do our core job functions the same as anyone else, but it's not fair to measure us on a quality the disability affects.
We don't get to ask a partially blind person to just look harder. We give them accommodations that let them do their job without relying on seeing.
It's called accommodation, not shielding from consequences.
I get to be late because I am not able to be always punctual. So my job has to accommodate me to help me do my job without relying on being on time. Just because I can sometimes try hard and be on time doesn't mean it's not a disability.
Depending on the job, being punctual can be critical to keeping customers happy.
If I’ve got a major customer complaining about a critical issue and has scheduled a call with various stakeholders (including us) to discuss/resolve it, then we can’t miss that call. Nor can we reschedule without extremely good cause.
If the disability affects a core job role then there are no reasonable accommodations. A blind person can't be a fire lookout, but they can be a host/greeter even though most customers would like to be acknowledged when they enter. the workplace just needs to make some changes to help the person.
also I'm not sure if 'customer wants the person not to do something' is undue hardship. If the employer says my customer wants to work with someone who can see my face when I talk, does that mean that employer doesn't need to accommodate blind people?
Like maybe the accommodation in your example could be to have another person on the team join meetings with you to provide a few minutes of coverage if you're late. If the job role really needs only one person to be exactly punctual all the time (does it really though?) then the eeoc advises to place the person in a different role with similar functions that aren't affected by the disability. read the guidance at eeoc.gov
Most of the time there are reasonable accommodations. It varies by person and the accommodations are specific to the role and person.
My point is that asking someone to just try harder is not the answer, and kind of ablist as it denies the reality of disability. Especially when you frame it as an accusation of laziness or an excuse to slack off.
Almost anyone can diagnose if a person is blind if they’re acting in good faith but ADHD is far harder to pin down. At the moment the layman standard seems to be “can you convince a doctor/nurse practitioner to prescribe you amphetamines?”
The ADA covers mental disabilities like ADHD so anyone who actually needs accommodations can receive them if they follow the proper channels and get a legitimate doctor specializing in ADHD to diagnose them. In a career spanning nearly two decades I’ve only ever met one other person who followed the proper ADA accommodation route with HR (as opposed to accommodations for blindness, deafness, or chronic pain which were legion).
Speaking for myself, even with a legit diagnosis it was little more than a cover and self justification for drug abuse (yay NP who prescribed both Vyvanse and Adderall).
I asked for accommodations once. I was fired a week later. Never again.
That said, I’m extremely happy with where I work today. I’ve been here almost four years and am still going strong.
how does you thinking some people fake disabilities and that you have a substance problem have anything to do with my comment on people framing accommodations as an excuse to slack off?
Are you suggesting that you think your diagnosis is invalid and that should be taken as a data point in our discussion?
I think the answer is for you to stop taking drugs, not that there aren't people woth ADHD who need accommodations to do their job well.
It's also not anyone else's job to diagnose you but your doctor.
If they cant or wont get ADA accommodations officially through HR, I don’t care what their doctor says (I don’t have access to their real medical records for obvious privacy reasons). They might as well have a diagnosis from a food truck chef.
It’s not my place to tell anyone whether they actually have a disability, especially one as pernicious as ADHD, but it’s also not anyone’s job to accommodate slackers who doesn’t follow the proper ADA process.
Next time someone uses their ADHD as an excuse to slack off, go talk to HR about what accommodations they requested and whether or not they’re reasonable. Forcing coworkers to pick up the slack for an existing assignment isn’t reasonable - ADHD accommodations are taken care of at the management and planning levels, not during standups. Stuff like flexible work schedules and office environments that minimize distractions are reasonable, but it’s not a get out of jail free card for one’s duties.
who are you talking about and how does that pertain to this discussion? The fact that someone could lie or not do procedure properly is not relevant to the people who do. It's kind of insulting to bring that up in a good faith discussion to imply that we're all fakers. If you'd like to reply to anything I said instead of calling people names I'd be happy to discuss.
Imagine telling a quadriplegic something like this, though. The neurodiverse, which ADHD is a part, are always being told we still need to measure up to the standards of the non-disabled in some form or another. It’s always about how we shouldn’t offload our struggles on others. There’s no wheelchair for us, almost no one cares if our workplaces aren’t accommodating.
100% this. This often manifests as "It's not your fault but it is your responsibility." Which is a great thinking framework when it helps you accept what you have and do what you can do mitigate it.
But here's the kicker: our "what we can do" will never be enough to be neurotypical.
We'll need help, even when we're using all our coping mechanisms. And if we don't get that help, the outcome is simple: we're going to fail.
In my experience, the line is drawn, brightly, in one place: does the "disabled" person genuinely try to work with others, or do they expect to be given a free pass because they played the disability card?
I have worked with some severely disabled people. (Probably more than you have, given one of my past jobs.) Most of them worked their ass off to make things work out and for that they have my eternal respect, my cooperation, and the benefit of the doubt.
I have also worked with some people who just throw their hands up and say "but I'm disabled" whenever they are asked to do anything they don't want to do. I do not respect those people.
What kind of disabilities? Visible (missing or non-functional limbs) or invisible (chronic pain, adhd, depression) ones?
More specifically, how do you know whether they could or couldn't do the things you were asking them to do, especially if it was an invisible disability?
Doing it before isn't a good indicator.
Other people with the same disability doing it isn't a good indicator.
Not visibly trying isn't a good indicator.
Having a blowout (or not) isn't a good indicator.
Being too tired (or too wired) isn't a good indicator.
These were not coworker or peer relationships, so I don't think your list/agenda here is particularly relevant.
The issue here is at the end of the day, there is work to do, and results matter.
Everyone has finite shits to give.
If everything is going fine, other people will often be willing to pick up slack or adjust. If other people are exhausted, overworked, or have no more shits to give - they won’t. Or more precisely, at some point they can’t. Or suffer negative outcomes themselves.
Disabilities are called that because they make things harder, for the people who have them, and for those around them. Same with disorders.
> they make things harder, ... for those around them
Agreed. I think the point I'm trying to make is simple, to abuse your examples here: Your not giving a shit is neither my fault nor my problem.
And to generalize it, "Your problem with my personal trait is neither my fault nor my problem." Be that trait a disability, skin color, sexuality, gender, or nationality.
Because unfortunately disabilities are just targeted as all those other ones when people want a scapegoat.
I might be getting a bit philosophical, but that's what this feels like it boils down to. Person A is vocal about their dislike of something about Person B.
If you say ‘should not be my problem’, then I’d agree since ‘Should’ usually means ‘I wish’.
The issue is that, like you note, it’s easy to ‘other’ people with disabilities and attack them, especially visible disabilities.
So then other people’s perceptions become a real problem for them, yes?
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> labeling ADHD a disability is a category error
No, it's not. According to doctors, scientists, and the ADA.
That factual inaccuracy aside, would you consider someone with chronic back pain to not have a disability since they can take heavy painkillers every day for the rest of their lives? Or someone who is legally blind but who can put on glasses?
Legally blind is tested with corrective lenses, if your vision can be improved to 20/200 in either eye by wearing glasses you wouldn’t qualify as legally blind (in the US)
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Heck, they have exoskeletons today, so I guess quadriplegics should just get that and walk right? There’s one more disability cured!
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That's a bit hyperbolic though, don't you think?
It's pretty unreasonable to compare one relatively minor disability to an extreme physical one that inhibits basic things like brushing your teeth or going to the bathroom.
ADHD doesn't stop you from doing those basic things does it?
For many people with ADHD it doesn't make things impossible, just much more difficult.
I think the point that the person you're trying to make is that too many people with an ADHD diagnosis think that being public with that diagnosis gives them a free pass to not over come the difficulties they face.
> ADHD doesn't stop you from doing those basic things does it?
Ironic that you picked those two - it absolutely does.
ADHD (and autism) have trouble forming habits - remembering to brush your teeth is something that's a real problem for most folks who have ADHD. Not to mention showering, deodorant, etc.
As for the bathroom, most ADHD people will hyperfocus to the point where they either don't notice they have to use the bathroom, sometimes for an entire work day at a time. Constipation and minor incontinence are not as uncommon as we wish.
> For many people with ADHD it doesn't make things impossible, just much more difficult.
Imagine you have a set of spoons with which to do work. For a NT, doing something like brushing your teeth is a habit, so it doesn't take a spoon. For a ND, the habit fails to form, so they have to exert mental energy to do it. Two spoons.
Keep this up for an entire day, and by the time you have to cook dinner, ND just don't eat because they've been out of spoons since mid-day. The NT cooks dinner and has a few spoons left over to work on their hobby.
Difficult might as well be impossible when you're out of energy. Or spoons.
EDIT: Wow. This blew up. I wouldn't mind chatting more about it.
Arguably the fact that someone is able to hyperfocus like that seems like an ability rather than a disability?
E.g. someone is able to focus on things that actually make a change while being in a messy room.
I don't need to imagine because I too have ADHD.
While I'm not also a quadrapeligic I feel confident that ADHD in general and quadrapelgia are not comparable.
I acknowledge that there are varying levels of severity of ADHD but very few of the instances of ADHD are comparable to such a profound disability as quadrapelgia.
You don’t compare disabilities, none are worse or lesser than others, it’s simply a disability. Anyone, even those with disabilities, who try and argue one type is worse off than another type are simply being ableist by trying to minimize or marginalize that person’s struggles.
Really?
You don't think that there are objective and measurable differences in disabilities?
Let's take plegia for example -- all other things being equal which is worse being monoplegic, paraplegic, triplegic, or quadriplegic?
Not recognizing objective differences in quality of life associated with varying disabilities does a disservice to those people with extreme disabilities and minimizes and marginalizes their struggles.
You’ve taken the opposite of what I said. Everyone’s disability is a struggle. Everyone’s life is a struggle. We help each other to navigate life and don’t compare.
Answer this: what’s the end goal of comparing disabilities? I’d argue it’s simply to minimize the “easier” ones. Every struggle is hard for the disabled, bar none. There is no logical reason to compare other than to minimize someone’s struggle, so just avoid doing that. Instead, try and figure out how you can help those around you who struggle, disabled or not.
Funny you chose that example… https://pubmed.ncbi.nlm.nih.gov/17587293/
Now show me the statistics on quadrapeligics brushing their teeth.
You used very poor examples and that’s okay. You don’t have to be perfect - it’s totally acceptable to wade into a conversation, realize you really weren’t qualified and back out. You don’t have to resort to this level of aggressive debate.
> I think the point that the person you're trying to make is that too many people with an ADHD diagnosis think that being public with that diagnosis gives them a free pass to not over come the difficulties they face.
Yea, and my point was: imagine telling a quadriplegic they should just try harder to walk, or alternatively that they should try to keep it secret. It’s a stupid idea.
You’re clearly uninformed about this topic, and should research it better.
> relatively minor disability
“Research shows that adults with ADHD are 5 times more likely to attempt suicide. 1 in 4 women with ADHD have made attempts on their life, while men are more likely to end their life. Accidental death is also common.”
http://www.berkshirehealthcare.nhs.uk/media/109514702/suicid...
Yeah, we tend to die earlier as well (65 on average, I recall reading). Turns out chronic stress from managing the disability is not great.
https://www.psychologytoday.com/us/blog/child-development-ce...
Now show me the suicide statistics on people suffering from permanent paralysis of their limbs.
I’m sorry bud, but I really don’t think you understand the topic. The idea is that people with different types of disabilities deserve an appropriate level of accommodation. It’s not a race or any kind of rivalry, or even a competition.
It’s about being a decent human being who can think critically.
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> Take your pills and put a bit of effort in and you’ll be fine.
Absolutely, categorically wrong. There's plenty of literature on the subject, should you wish to correct your assumptions.
For those with serious symptoms, medication can help make it possible to use coping strategies. It doesn't make it easier, just possible.
To put it another way we'll never be neurotypical (normal), and if that's your expectation for someone with ADHD, that's not our problem.
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Congratulations on having ADHD at a level where your coping mechanisms work (and appear to work pretty well). Not everyone is so lucky.
Or to put it another way, a broken toe and a broken femur are both categorized as broken bones, but one is much more serious and has complications the other does not.
We understand that your disability is much worse than the rest of us. Everyone else should stop what they’re doing to accommodate your severe disability.
This is why I don’t want to be diagnosed. I only claim to have probable ADHD when I am trying to help other people who do or might do.
Without claiming any disability, I say what I’m good at and offer to do it. I am respected for what I contribute and forgiven for what I don’t.
I married someone who does planning, she married someone who makes money on his ideas. She runs my business, I talk to clients and teach my classes and (slowly) write books.
> it's like trying to teach advanced machine learning to someone with an IQ of 100. No matter how well-intentioned the advice or how clear the potential benefits, there's a fundamental mismatch between the cognitive requirements of the task and the available cognitive machinery.
This obviously isn't core to the point OP is making, but I find it hard to believe that someone of "average" intelligence can't learn about advanced machine learning.
What is obvious is that OP is really into IQ elitism. Looking at the ‘A More Realistic Framework’ suggestions, it asks people to aim for the bare minimum.
No, it's not suggesting the bare minimum. It's asking the person to openly do what can be proven to provide the best value as long as the missed administrative tasks or fails are down-playable enough to not damage your reputation. This is a very easy framework for me to funnel my thought process through.
Recently, I've been in the position where I'm the only one taking ownership of new work and initiatives, sometimes to my own detriment. For example, I took on a feature that required an entire validation system be put in place. Though I succeeded in successfully completing the system, the feature was not fully complete. The validation system was not visible. Though if leverage, it would lighten everyones load, it largely went unnoticed and what was observed was that I pushed out a buggy feature. Though I resolved the bugs within a sprint, my reputation was damaged to the point where I took on a new feature and promised it would be done in a sprint. I succeeded but wasn't able to complete it due to the api team only finishing 2-3 of 8 apis. This sort of test I made for myself also had low visibility so even though it was an impressive feat by my team's efforts, it also largely went unnoticed.
Though the author is wrong to equate work-throughput with IQ, he's right to find a way to inform trusted management with this work ethic and he's right to make sure when high value tasks are taken on, that it be made clear to product so credit can be given.
I have team members that are doing the bare minimum but cross lots of t's and dot many i's and that gets them equal recognition as me who often misses deadlines but does lots of heavy lifting.
On the bright side, what you’re doing sounds more fun than crossing lots of t’s
I think it is core — the premise is that ADHD in some presentations makes basic administrative/maintenance activity difficult or impossible.
With machine learning, the concept or layman level explanation to support the application of the tech is definitely doable for the average person. But the average person won’t be able to get the math.
Folks I know with ADHD generally adapt well, with systems or coaching that they get from professionals or folks supporting them. Everyone is different, of course, and folks struggle with different things.
He’s right with the other stuff too imo. People who deliver get grace from non-core failures.
It is interesting that you did opt to add in the word "about".
Maybe if they really like math? I think there’s probably some correlation to being able to easily reason about these things and enjoyment.
So while you could teach anyone, with enough effort, they would not actually enjoy the experience.
> can't learn about advanced machine learning.
There's a difference between grokking an ELI5 explanation and being able to build, modify, or review an existing ML model
And that difference is mostly down to having domain-specific knowledge, which is not something an IQ test measures.
Can someone with a IQ of 100 (whatever that means) understand and implement stochastic gradient descent?
Maybe - but very possibly not.
I think they are right. Advanced ML requires both IQ and career dedication. Doing say the intro YT series building yoyr own LLM and understanding and sucessfully using PyTorch data strucutres in 3 even 4 dimensional (as in an array of array of array of arrays) doing matrix algebra...
I would say this gets possible at 120 and only easy at 140 at a guess.
Edit: i am serious
Anecdotally, as part of my job, I've taught ML concepts to a lot of people. I don't know if I've ever worked with anyone who was simply too "unintelligent" to grasp things. The bottleneck, as for most things in my experience, is time and motivation. In any niche of ML, there's just a lot of things to learn, particularly if you aren't starting with a particularly math-y background.
You were probably working at a fairly advanced tech company. As were the people you were teaching.
If by "ML concepts" you mean "how to implement ML" - do you really think that people who got to a job that required learning this, represent the population IQ distribution?
I cannot tell if you are serious.
How many people of 100 IQ could even develop a working knowledge of the necessary linear algebra?
Most college students I took it with, probably average a standard deviation higher, did pretty middling in the class.
I "have" ADHD, although I don't believe in it conceptually and I don't take any drugs for it. I think if you poly-score people on impulse control, attention span, time sensitivity, organic recall of pertinent time-sensitive information, etc. you'll find that if you arrange all the scores from best to worst everyone under the 40th percent mark "has ADHD". Below maybe the 10th percentile you'll find that without stimulants it's unlikely that the person will function well in a task-based time-sensitive environment with delayed feedback loops for task completion.
Accepting the framing that ADHD does exist, it feels like brain damage. Every year growing up, in any group of kids I was among the most immature, the most off-task, the most distracted, and the most forgetful. I am plenty smart, move very quickly, and have accomplished plenty, but my entire life has been defined by being more bored, forgetful, and immature than nearly every single person I've been close to. My wife (performs very well on relevant metrics) says it's extremely noticeable and unusual from the outside. Over time I've learned to heavily lean on coping mechanisms (my phone rings about 35 times per day with timers I snooze tactically, I leave my keys in my bag any time I go places so I can't leave without the bag, etc.) No amount of character development schemes, punishments, shaming, positive skill practicing etc. has changed my natural proclivities in the slightest, although many days of good sleep and diet can sometimes produce a bit of a sustained flow state. Sometimes I wonder if I just lack some kind of ion in my blood.
My coworkers sometimes tell me they feel like they have ADHD. Then I watch them listen to someone talk about a subject they find boring for 5 minutes without drifting off or fidgeting, and then remember off the top of their heads to respond to outstanding emails. Come on guys, if we're going to make up conditions we should at least reserve the label for people that it describes accurately.
> I "have" ADHD, although I don't believe in it conceptually
Congratulations on getting your Doctorate of Psychiatry. Glad you've single handedly debunked a century of study with your belief.
On a more serious note, I'm glad your symptoms are addressable with coping mechanisms. A lot of folks can't. And your "40%" is actually closer to 5%, based on scientists who research and give talks on this mental disorder.
I think their opinion is along the lines of “no one is ‘inflicted’ by ADHD, and there is also no permanent cure for it, because the disorder can simply be redefined as being those who are in the lowest quartile or even the lowest 10% of X, Y, Z cognitive metrics.”
Imagine there were a pill that could boost your IQ score by 25% but in order to receive a prescription you need to have an IQ in the lowest quartile. Such a pill could also help already smart people simply become smarter.
Thats the main contention: there are two groups: (a) people who actually experience debilitating symptoms that significantly impact their life requiring medication, and (b) people who are simply looking for an edge by using medication, perhaps even convinced to do so by ads on TikTok or Instagram under the guise if ADHD.
Edit: The IQ score medication analogy is only meant to be illustrative. I don’t mean to imply that IQ and ADHD are somehow connected.
> because the disorder can simply be redefined
Respectfully, disorder already has a meaning. And it's a meaning enshrined in medicine and law (ADA). "Redefining" disorder does nothing but hurt people who have a disorder.
And ADHD has no correlation with IQ (which I think you know, but it' not just a focus sliding scale either). It's a disorder that encompasses the symptoms of time blindness, a lack of ability to control focus, emotional disregulation, rejection sensitivity dysphoria, reduced working memory, an inability to form habits, and executive dysfunction.
It's also associated with a physical change in the brain.
I added an “edit” to clarify I don’t believe IQ and ADHD are connected.
“Redefining” could have instead said “Reinterpreting”.
The reality is the diagnosis for these disorders are completely subjective. The same logic could be applied to depression and SSRIs. It’s not like a blood test that tells me I have high cholesterol. It takes dozens of hours with a qualified medical professional to seriously diagnose someone with high confidence.
Also agree there are studies correlating it with physical changes in the brain. But those studies aren’t fully fleshed out and not useful for diagnosis. There isn’t a brain scan that can detect ADHD.
> There isn’t a brain scan that can detect ADHD.
I think it's important to note that even if there were, it wouldn't change the inherently arbitrary nature of ADHD diagnoses (as opposed to the more objective presence of a bacterial infection or an ACL tear). Such a brain scan would legitimize the careers of thousands of people and be deeply celebrated by insurers and physicians alike, as it would dramatically simplify the diagnostic procedure, but the scan would still just be "identifying brains that fall into several of these metrics 1-N we wrote down in the DSM". It would be possible to change the DSM such that the brain scan would have to be adjusted as well, which is very difficult to do with other conditions that are more obviously "real".
My two cents, although I admit I've put more like six cents into this thread in total, is that 95% of the suffering that those "with ADHD" experience come from poorly-designed schools and businesses, which keep them captured, tracked, and timed for deeply questionable societal benefits. I'm not about to say you can operate a space station or manufacture semiconductors or supply the US cold stowage network without a good amount of capturing, tracking, and timing, but I am going to say that much of the psychological torment ADHD-havers endure is because they're failing to live up to stupid, useless goals set by people with misguided ideas about why the goals exist.
100% agree.
(I don’t normally reply just to say that, but it felt relevant given the thread)
You misinterpreted the part of the comment you referred to. They aren't referring to redefining the word "disorder", but "the disorder", as in "ADHD". What they were referring to with the definition is how the definition of ADHD is completely arbitrarily defined, as the diagnosis isn't based on any genetic marker.
> ... how the definition of ADHD is completely arbitrarily defined, as the diagnosis isn't based on any genetic marker.
Did you know that 90% of cases of ALS aren't "based on any genetic marker"? Does that mean ALS is "arbitrarily defined"? What does that even mean? Are you saying it isn't real?
> the diagnosis isn't based on any genetic marker
Neither is depression, PTSD, autism, chronic pain, schizophrenia, narcissism, MPD, and so forth. But they all exist. And they can all be debilitating to the point of becoming a disorder. They all have treatments according to their classification.
Being invisible doesn't make it not be a disorder.
We all agree it’s a disorder. No one is debating that.
> I think their opinion is along the lines of “no one is ‘inflicted’ by ADHD, and there is also no permanent cure for it, because the disorder can simply be redefined as being those who are in the lowest quartile or even the lowest 10% of X, Y, Z cognitive metrics.”
That's not how ADHD is defined, though.
> Imagine there were a pill that could boost your IQ score by 25% but in order to receive a prescription you need to have an IQ in the lowest quartile. Such a pill could also help already smart people simply become smarter.
Yeah, that's a nice hypothetical but that's not how ADHD meds work; boosting dopamine out of the normal range does not continue to have beneficial impacts to executive function, instead it leads to anxiety, insomnia, aggression, and hallucinations. That's one of the reasons dosing for ADHD meds tends to start on the low end and be carefully titrated up to what works for the individual.
> That's not how ADHD is defined, though.
How is it defined?
> that's not how ADHD meds work
Are you saying no one without ADHD takes prescribed medication?
When I was in college people with prescriptions would sell their pills for $5-10 each (10+ years ago in Boston). That’s $300 for a month supply purchased by fellow students who weren’t diagnosed, but used it to cram for exams and studying and concentrating during exams.
If what you say is true, then the free market (black market) for adderall wouldn’t be so lucrative.
Perhaps you haven’t been exposed to the plethora of Instagram ads convincing kids they have ADD based on a 5 question survey and prescribed without any other criteria besides “is trouble concentrating impacting your work or personal life?” - these days it’s literally that simple, quick telegealth appointment, say concentrating impacts your work life, and there you have it, you officially have ADD.
This thread is going on a ton of tangents. My original point was simply that diagnosis is subjective and relative to the people around you. Second point is the meds will help anyone who takes it with improving concentration and making it possible to increase productivity substantially not just for short bursts but for extended periods of time (months/years). I think both points still stand
(And none of what I’m saying invalidates the seriousness of the disorder for people who “really have it”. I fully believe there are people who find the condition truly debilitating. But there are also loads of people who are diagnosed through instagram or TikTok ads because “concentrating is hard” and “motivation is difficult” and other obvious statements that resonate with a majority of college kids, for example)
> Are you saying no one without ADHD takes prescribed medication?
No, I'm saying that the cognitive effect on function of someone without ADHD taking ADHD medicine isn't the same directionally as that of someone with ADHD taking it, the way the upthread proposed analogy of "a drug that increases IQ score by 25%" but which is only prescribed to those with IQ in the lowest quintile framed the situation. Excess dopamine impairs function in a different way that dopamine deficit, it doesn't increase it beyond what is seen with normal dopamine.
> If what you say is true, then the free market (black market) for adderall wouldn’t be so lucrative.
It is true, but the black market for adderall isn't mostly taking it for the same effect as people with ADHD are (some are, because there are still biases and access issues which prevent or delay diagnoses for people with ADHD, as well as deliberate, government-created supply shortages in the legal market.) But largely are taking it for wakefulness (an effect of dopamine surplus), and because dopamine surplus is part of the brain's reward system such that things which have been experienced which produce it are actively sought out. Again, this is why therapeutic dosages for ADHD are titrated to avoid going overboard.
You should add an email address to your HN profile since HN frowns on replies like (but I’ll post it anyway):
I fully agree with your comment, and good take!
Queue https://www.latimes.com/california/story/2024-06-13/teleheal...
Everywhere, all the time, at all age brackets. It's absolutely terrible, having suffered a terrible amphetamine addiction in my past.
Sufferers of real ADHD need to understand that when people critique the guidelines, they're critiquing the fact that this is possible, and its leading to serious problems getting on with life.
I think they're just in a bubble, gotta remember that in tech the percentage is bound to be a lot higher Then for the general population.
You're also taking that initial statement way too serious, the rest of the comment kinda contextualized it and essentially admitted that it does exist, but that it's more of a range then a binary. And that's in line with the medical science.
I've actually never heard anyone describe it as a binary, but maybe that's just my bubble.
Thanks to another prevalent symptom of ADHD - emotional disregulation - I very well could have overreacted. In my defense, the "It's not a real thing" and "you're just lazy" really get old after the 100th time hearing them this week.
Control over concentration is only one symptom of ADHD, and there are discernible differences that make ADHD brains look different in CT and MRI scans. So it's a bit closer to binary than "everyone in the world is somewhere on the ADHD spectrum".
Plus, the final word in the ADHD acronym is "Disorder" - so if it's not impairing your ability to live and participate in society, by definition you don't have ADHD.
I wouldn't say you overreacted. It's impossible to both convey and read tone over the internet, so there's no way for you to know that I don't mean to be insulting. I also like to write in a polarizing and cynical manner.
Whatever negative label you've had applied to you as a result of ADHD, I likely have had the same applied to me. My choice to not use any stimulants is both indeed a privilege of my "symptoms" not reaching a point where I can't function in day-to-day life, but also an ideological choice, because I have hurt my own career, screwed up projects, and progressed much more slowly than I would have if I were on Adderall or Ritalin or whatever else they're prescribing now.
The reason that I persist with the claim that "ADHD doesn't exist" is exactly what you said here:
> If it's not impairing your ability to live and participate in society, by definition you don't have ADHD.
The problem is not my brain, the problem is the arbitrary demands of society. This is not an emotional attempt to preserve my self-esteem--I like myself just fine and always have--but a pragmatic observation that diagnosing "disorders" with acronyms and developing "treatments" legitimizes the framing that the society that I'm chafing with as a result of having some cognitive deficits relative to the rest of the population is somehow more "real" or "official" or "objective" than I am.
It's like if every day to get to work, you had to walk up huge stairs, and anyone under 5'6" had a tough time getting up the stairs, and then doctors came up with HDS (Height Deficiency Syndrome) and prescribed growth hormones and stilts. You get a bunch of people walking around on stilts telling each other they have HDS. Over time, you barely even need to be examined to get a stilt prescription, they just give you the HDS diagnosis soon as you look like you're not going to pass 5'6" by 18. Now you've got a society that is comfortable with the knowledge that short people have HDS and tall people don't, without thinking about the fact that whoever built the stairs could simply have made smaller stairs that other people could walk up more easily.
I would really prefer that people start wondering en masse if, in the age of incredible technological abundance we currently enjoy, it's really necessary that every industry, even ones that don't require highly time-sensitive detail-oriented work, function with the rigor and precision of a munitions factory.
> the problem is the arbitrary demands of society
Well, society isn't going to change to make 5% of the population with an invisible disorder better.
And I think even given that, the "it's society that's the problem" is still wrong. Because (from another thread), ADHD is more than just a concentration problem. It's a disorder that encompasses the symptoms of time blindness, a lack of ability to control focus, emotional disregulation, rejection sensitivity dysphoria, reduced working memory, an inability to form habits, and executive dysfunction. No number of "hunter gatherer" society norms would explain all of these.
From the guidelines: "don't be snarky".
I disagree strongly with the grandparent comment, but this is about as useful as commenting "Congratulations on getting your Doctorate of Sacred Theology. Glad you've single handedly debunked a millenium of study with your belief" would be when I comment that I'm an atheist.
FWIW, this comment falls afoul of the guidelines as well, and is even less useful since I did follow my opening with a real discussion. To quote the guidelines, report it to the moderators if you feel it's sufficiently problematic.
Have a good one!
I didn't say that your comment was an egregious violation of the guideline - had it been, I'd have reported it instead.
I reminded you that the guideline exists because it's good advice in this case, and had you edited your comment to get rid of the snark (as the guidelines suggest), you could have had a chance of persuading instead of alienating its audience. Too bad.
MRIs show study after study that ADHD is real. Its been shown that ADHD is either the inability or significant reduction of processing dopamine, or the inability or significant increase in dopamine production. That’s all there is to it.
Tell a blind person to simple try harder in seeing, and that you don’t believe being blind is “a thing”.
At its core, ADHD's main mechanistic difference is undeniably an executive function deficit -- the frontal lobe not being activated enough to properly regulate functions of the rest of the brain or exert executive planning and follow-through.
The "paradoxical" effects of ADHD stimulant-type medications is the most direct indicator that this is indeed the case: taking a CNS stimulant normally causes more arousal, agitation, and activity in NT individuals.
But in ADHD individuals, CNS stimulants up-regulate frontal lobe activity, which manifests as a relaxant, since the frontal lobe is doing a better job of regulating and stabilizing the rest of the brain. Executive function also improves considerably.
So the most objectively measurable symptom of ADHD is whether this paradoxical behavioral alteration occurs from taking a CNS stimulant.
You can argue all you like about whether ADHD is within this or that percentile threshold -- but you can't argue with a proven, consistent, clinical result that points strongly to under-functioning of the frontal lobe in individuals with ADHD.
I've experienced this myself. My quality of life is profoundly different after taking Ritalin. I feel more relaxed; the buzzing and noise in my head is significantly reduced. I stop feeling the profound urge to get distracted like Doug the dog from the movie Up: ... "squirrel!"
I don't understand why people consistently seem to think that I am telling people that their experience "isn't real" or that their brains and behavior aren't different from the majority, or that everyone can get around it by "trying harder". None of that is what I'm saying. I could be diagnosed with a real, clinical case of ADHD pretty immediately if I so desired. Going by the dictionary definition, I "have it" and have "had it" for my entire life. My father "has it" to the same degree that I do and is medicated for it. My life has been a great deal harder than it would have been had I taken stimulants.
My point is that, unlike people who have a fracture in their femur vs. people who don't, the "significant reduction" of dopamine processing metric, when codified, is a pretty consistent, smooth line across the population. There are a group of people who are seriously dopamine-processing-reduced, and then a huge grey area with people who kind of are and then kind of aren't, and then there's group of people whose dopamine-processing ability defines the "baseline" against which ADHD is constructed. ADHD is a four letter label that was only invented to help doctors help people deal with difficulties they have with executive functioning, given that modern society demands a baseline of executive function out of citizens if you want to receive food, shelter, salary, and promotions.
In recent years, the "ADHD boundary" has been expanding to capture more people in the grey area as doctors, psychiatrists, and insurers play looser with the definition of ADHD than they did when it was first invented. But at its core, the condition is literally "compared to this other group of people, you have a harder time at certain important tasks than they do". Is that a "real condition" in the same way that COVID-19 is a real condition? I say not; it's a methodological shorthand.
I am very aware that the brains of certain people work differently than others, and that in "ADHD brains" (a group which includes mine) it is possible to use a brain scan to observe differences relative to that "normal group of people". But if you took scans of the "least ADHD" group, you could find that their brains differ as well, and they have certain cognitive advantages compared to the new baseline of middle-ground brains. We could call that "Attention Surplus Normal-activity Advantage". But it would be stupid to label them with ASNA. Everyone would be aware that the four-letter acronym is just an arbitrary shorthand to describe a group of people that can be diagnostically clustered together relative to everyone else. The "advantage" would be exactly as real as the "disorder".
> study after study that ADHD is real. Its been shown that ADHD is either the inability or significant reduction of processing dopamine, or the inability or significant increase in dopamine production. That’s all there is to it.
Its not, though, because while the dopamine/norepinephrine chain seems to be the main issue in ADHD, serotonin also seems to be implicated, as low serotonin levels are associated with it and serotonin-targeting interventions also seem to help.
But, yeah, your more general point is correct; ADHD is undeniably a real condition.
I have to constantly fight the struggle OP is describing, and one thing I’ve never tried is being upfront and honest about my shortcomings… I just get upset with myself and start writing post it notes about doing better, actions to take, and sticking them all over the place. I can’t even imagine the world where I share this about myself and it’s well received by people who, at the core, just want me to deliver a very steady stream of work they can plan for.
You don't always need to announce it to everyone. You can try talking to HR and asking for accommodations (which someone with ADHD is eligible for through the ADA). And the nice thing there is you don't have to tell anyone else.
Accommodations can include things as simple as leeway for coming in late, or with deadlines. They can even go up to removing specific requirements from your role.
It's worth asking what's available at least.
I was diagnosed with ADHD but I still think of myself as a lazy cunt. That probably doesn't help reputation either, I'm sure I project this belief outwards, even unintentionally. Other ADHD-afflicted individuals I've talked to about this report similar.
My neurologist has a LOTS of patients. All of those with either Autism or ADHD / similar symptoms claim that they feel they don't get enough work done.
I start to believe that we are overly self-critical, and that the actual workers are having better ways of hiding their incompetence :D
If you felt satisfied with your productivity, why would you seek help? So there's definitely a selection bias there. Likewise for those whose "locus of control"[1] is biased toward external factors--i.e. you ascribe lack of success to factors outside yourself.
Similarly, AFAIU, time and energy spent in self-reflection also tends to positively correlate with neuroticism--e.g. feelings of guilt and inadequacy. If you're not high on self-reflection (there's a negative correlation with extroversion), you're less likely to experience negative self-esteem, at least in a conscious way.
I know ADHD correlates more strongly with some personality types than others, but by and large I believe people with ADHD (like everybody else) are spread across the spectrum along all these various axes, and it's only at some ends of certain axes that they're likely to seek assistance for themselves.
[1] https://en.wikipedia.org/wiki/Locus_of_control
> overly self-critical
IMO this relates heavily to Rejection Sensitive Dysphoria and ND people's propensity to maximise negative self-perception and minimise positive.
Not working with too many people better than me has been terrible for my learning, but amazing for my self-confidence.
I've been diagnosed, and both before and after, sheer terror of being seen that way has helped keep me generally productive at work for decades. But I run into something that seems related - I feel like a fraud, particularly when I get compliments or recognition at work. Yes, I am actually doing the work - it. But I know I could be far more effective if I could focus better. So I always feel like I'm only accomplishing a small fraction of what I could... and I expect people to realize that any moment now.
I had this happen at my last job. Got a new boss who was closer to the situation and ended up bouncing me over the course of a six month pip. I was so bored, and the hard problems always got taken by the same guy who they’d just hand stuff of to.
At my new job I interviewed into a promotion and am a team lead. My focus is always on whatever is the most challenging technical tasks. Once we finish building a product, someone else takes over maintenance and we get a new project. It’s fantastic because I’m always at the edge of what I know and writing brand new stuff, which I exactly what I love. I find this deeply satisfying and it helps rebuff that feeling of being a fraud. I definitely prefer to be a medium sized fish in a small pond (where I’m a pretty smart guy at a place that doesn’t necessarily need world class engineers) vs being a medium sized fish in a large pond.
The more boring my work is the worse I do at my job, and I’m lucky that in my position at this point I basically only focus on the novelties and intricacies of the most challenging tech problems the company has to offer.
> I feel like a fraud, particularly when I get compliments or recognition at work. Yes, I am actually doing the work - it. But I know I could be far more effective if I could focus better. So I always feel like I'm only accomplishing a small fraction of what I could... and I expect people to realize that any moment now.
This is imposter syndrome[0]. Particularly feeling like a fraud, disassociation from compliments, and expecting people to find out you're a fraud. I think it's fairly common for some jobs/roles (software developers at Google, for example). I also think it's fairly common for people with ADHD.
You can still do more and do better (e.g. by better coping with your ADHD symptoms), that's normal and healthy to an extent. It's just that your self-perception is probably a bit too negatively biased. It's normal to have a negatively biased self-perception, but my guess is that your self-perception got warped a bit too much from decades of "sheer terror".
I can't really speak directly from experience with imposter syndrome, but what currently helps me deal with negative self-perception is acknowledgement and acceptance:
* cognitive reflection: Understand and acknowledge that many of my self-thoughts are negatively biased[1].
* meditative reflection[2]: Practice unconditional acceptance. Accept everything, accept my own performance, accept my negative thoughts of my own performance, accept my feelings of ineptitude.
... Unless "I'm only accomplishing a small fraction of what I could... I expect people to realize that any moment now" actually means that you expect people to find out that you're secretly really awesome and deep-down you're actually way better than all of them. That's probably not imposter syndrome.
[0] https://en.wikipedia.org/wiki/Impostor_syndrome
[1] https://en.wikipedia.org/wiki/Cognitive_distortion
[2] I don't really meditate per se regularly, I'm trying to illustrate that there are different ways to mentally reflect. Rational, logical, emotional, spiritual, whatever.
You're just carrying on what you were called by your parents, teachers, coaches, and peers. ADHD and being called lazy is common. And when we're told that so frequently, we begin to believe it.
Even though it's not true. Sometimes no amount of mental effort can break past the barriers we face on a daily, hourly, even minute by minute basis.
> still think of myself as a lazy cunt.
Unrelated, but "spot the Australian"
Might be an Australian but at least not an F*ing Australian
~ This Is Serious Mum (https://en.wikipedia.org/wiki/www.tism.wanker.com)
to see yourself as a "cunt" is definitely rather unhelpful for just about anything.
> Being explicitly upfront about your administrative weaknesses early in relationships
This sounds like a Good Thing, and I'm sure for some people it's a good idea, but in my experience, frontloading this sort of stuff tends to backfire. The problem is that most[0] people don't know how to deal with special needs[1]
If you focus on the facts and "your administrative weaknesses" a lot of people just hear excuses and think you're incompetent.
If you try to explain it as a medical thing first, you might get the "you don't look autistic" response -- they think you are putting yourself down -- but the response I've had even more often is "what does that mean?". Now you have to work to convince them that you are a liability.
A strange game. The only way to win is to not[2] play.
[0] "most": a population large enough that you can't safely ignore their existence. Source? what I reckon.
[1] I don't really like to use the phrase, but I mean the literal meaning of the words and also that's often how they see it.
[2] not the only way to order words
For me that would just be another reason to avoid the person and spend the time instead with people who are easier to get along with.
That doesn’t make me a dick, I just have a limited number of hours on the clock and energy to spare.
I have ADHD and sometimes my brain wants to do admin work but sometimes it doesn’t. It’s actually hard to predict, so that makes it even worse. If I do the admin stuff one time then people assume I’ll always do it but then next time I let it slip and that has negative consequences.
It kind of feels like I’m just a passenger and my subconscious is doing the driving in terms of my decisions if what to focus on.
I don't officially "have ADHD" but I have related things that often come with "ADHD-like symptoms" which as I've gotten older seem to either get worse or just come to the forefront more. So I open this article looking for something and... man, it is really shocking and bizarre to see basically my entire life-success strategy independently written down by someone else.
Some are worthy of specific comment:
> These suggestions assume that the primary challenge is knowing what to do rather than the neurological capacity to consistently execute such systems.
YES YES YES YES YES. I am utterly sick of being told to make a to-do list (thanks, therapist, last Monday). I have a list. I have a half-dozen discarded lists. Lists are not the problem. Someday I will find the solution?
> Be exceptionally helpful when you can, so people are more forgiving when you drop administrative balls
It's kind of hilarious to see this written down, because usually when people seek me out for help (or I go to them to help)... it's something novel or at least a change of pace for me... so it automatically activates the novelty circuits in my brain and I get really into helping out anyway. Brains are weird.
> Being explicitly upfront about your administrative weaknesses early in relationships
This one caught some flak upthread but for me it is as simple as saying "hey, I'm not always great about responding to pings, if it's important just ping me twice and that usually works" (which, for me, it does). Saying that kind of little thing explicitly can go a long way.
> it's like trying to teach advanced machine learning to someone with an IQ of 100.
Everyone already agrees this is ridiculous, but I have to say it too: this is ridiculous.
> I have a half-dozen discarded lists. Lists are not the problem. Someday I will find the solution?
I haven't, but I can say that it's not journals. Though they do make pretty stacks when you collect them.
This article hits home so precisely -- not personally but in terms of those who I've worked with in the past, and in particular the reputation bits.
It was been painful to watch, to be honest, because the impact on our team had been so acute, and it simply never got better after so much effort on the part of management, other engineers, etc.
Where I diverge with base assumptions however is that I suspect these particular people had been misdiagnosed with ADHD, were given medication, and it was the medication that led them to drop the ball. Why? Basic physiological needs were never being met, again and again. They were constantly reporting insomnia, missing meals, fatigue and all of the things you associate with stimulants being either misused or abused. Having _been there_, it was easy to spot. And I think this sort of thing is tragically common in our field, and is rarely confronted because of identity issues associated with medical labels.
You seem to be saying that people presenting with classic symptoms of ADHD clearly don’t have it because stimulant abuse can also cause those symptoms?
Sure, people get misdiagnosed or purposely lie to get meds, but tons of people legitimately have the condition. Insomnia, poor basic self care, and fatigue (hello insomnia among others) are 100% symptoms of the condition. Taking medication doesn’t “fix” ADHD, it helps some people cope better in some ways.
I'm speaking only to the high rate of over-prescription and misdiagnosis (this is a fact), and how it's very likely that more than a few people are finding their lives more difficult with medication. The potential for spiraling out is certainly there with amphetamines, and it can sneak up on you, especially when basic physiological needs are no longer being met. Having known these people for a good while, I think they fell squarely into this category.
You’re not a doctor.
I have adhd one way I get myself to do my administrative tasks is by trying to somehow mentally connect it to a goal that I am hyper focused on already. Another thing that helps me personally is running as it helps me center my thoughts to find my next step to advance to the goal(s) I am trying to achieve.
If you're interested in figuring out how to gain focus / concentration in life without having to get an adderall prescription, look into Samādhi.
small disclaimer: You probably can't choose to only gain focus / concentration if you embark on this path. Other stuff is going to come along with it, since technically speaking, you'll be unveiling the nature of consciousness in the process.
There's is sort of a natural efficiency in forgetting some things.
Sort of a sieve of things that weren't worth doing anyways.
It's less useful that the things most often set aside are the most mundane but required parts of life.
For example: brushing your teeth. Showering. Getting prescriptions. Scheduling and following through with doctor's appointments. Paying bills (thank the gods for autopay). House repairs. Calling someone to do house repairs. Going to meetings at work. Remembering to leave for work on time. Remembering your wallet.
And so forth.
I have extreme adhd. I have zero struggles with what the article describes. I am extremely detailed oriented in every aspect of my life. I just can’t bring myself to sit and work on the most difficult and meaningful things unless they’re highly novel and I happen to find some sort of groove which is usually short lived.
Not sure the point of my comment. Maybe just to shed light on now it can be different. I would also never in a million years admit my adhd in a professional setting. It’s really stigmatized
I'm also the complete opposite of the ADHD types who forget things, are late, miss details, etc. I'm pretty sure that happened because I subconsciously developed a whole series of tactics and systems to make life less challenging over the years. But that just added new issues around living and dying by to-do lists, becoming addicted to "accomplishment" (at any level), constantly in my head 24/7 about what I need to do next, what hasn't gotten done, how I'm going to do all the things I want to finish. Also wouldn't dream of announcing this to colleagues.
> it's like trying to teach advanced machine learning to someone with an IQ of 100. No matter how well-intentioned the advice or how clear the potential benefits, there's a fundamental mismatch between the cognitive requirements of the task and the available cognitive machinery.
couldn't the same be said about adhd? or looking at it from the other side by the author's terms wouldn't a sub-100-iq machine learning enthusiast be also entitled to special treatment so s/he can work with it? isn't it fair to say that adhd relates to non-adhd like sub-100-iq to plus-100-iq? again, just taking the author at face value.
Maybe I have something like thus but admin tasks are a real challenge. Monday morning my heart wants to code and be in flow... but I know I need to plan future initatives, communicate stuff and worst of all make phone calls for personal stuff.
This is a pretty good article, from my point of view as an undiagnosed probable ADHD sufferer (I dropped out of high school over this kind of thing).
I wrote a book about my coping strategies— which invert most of the common productivity-fetish advice. For instance, I value procrastination. It has important benefits.
A key move for me was to stop thinking of my mind as if it were a power boat and start thinking of it as a sailboat. Hence my book on professional self-education: Secrets of a Buccaneer-Scholar.
Another key move was to recognize that discipline is not my road to getting things done. Rather, my motivator is helping people.
I am also usually very careful about what I promise. Most of my promises are to do things that I have already completed, or as near as.
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Never have I ever read such a pile of bull.
Of cause everybody prefers the new and shiny but not executing on what's important is simply lazyness and lack of will.
The cherry on top is the comparison of the impossibly of teaching advanced machine learning to someone of average IQ -- clearly indicating that they assume to be of higher IQ since they have grasped that topic.
OP seems to be a low performer thinking of himself as high performer held back by circumstances and not themselves
Your comment comes off uninformed and rather nasty. Do you also think that people with depression are just lazy as well?
I highly recommend taking at least a little time to read up on our current (highly limited) understanding of brain science.
I do agree the use of “average” IQ as a disqualifier for understanding ML is pretty rotten though.
> Of cause everybody prefers the new and shiny but not executing on what's important is simply lazyness and lack of will.
Then explain why do mice that were modified to have similar deficits in neurotransmitters exhibit the exact same "lazyness and lack of will".
https://www.nature.com/articles/s41398-024-02893-0
In normal people, dopamine and norepinephrine are released in certain parts of the brain while performing routine and administrative tasks and also anticipation. In people with ADHD, it doesn't happen properly. If a (cruel and unethical) experiment was performed on you where your dopamine signaling was lowered, you'd understand this in a jiffy.
May I suggest not downvoting this into oblivion? We need to shine a light on this type of thinking, as it is representative of many others towards ADHDers (including many ADHDers themselves...). I have this wrestling match internally on the daily - "Am I being lazy right now or suffering from ADHD? Can I power through with determination and grit, or soften my approach and do an end-around using tactics learned in therapy?" Magnify that x1000000.
We've all encountered (in person or online) self-diagnosers, and even worse, those who make ADHD their entire personality, and calls for the world to change itself to make life easier for others. If that's your most frequent engagement with ADHD, I get how you could have OP's type of response.